Pancho - LOP-PAT-67

Code: LOP-PAT-67
Mercy ID: V-00025-01
Encounter Date: 01/11/2000
Last: Lopez
First: Patricia
DOB: 03/17/1967
County: Cobb
Street: 560 Power Spring Apt-24B-1
City: Marietta
State: GA

Zip

30064-

Home

(770) 792-7324

Family Status

Adult coupie-no children

COB

Guatemala

Gender

Female

Housing

Doubling Up

Education Level

College Degree

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	N/A
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: YES
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perez
Data Entry: D. Gomez